Money and Power: Redefining Federal–Provincial Health Care Roles

As the provinces and territories joined the medicare program, each provincial or territorial health minister quickly recognized the impact of inflation on the costs of health services. To address this issue, they began to hold semi-annual meetings, occasionally inviting the federal minister. But as the federal position changed from support for 50 per cent funding to a determination to cap spending at sustainable levels, the provincial meetings became a forum for the development of a united front to seek more federal funds for innovations such as optometric services, drug benefits, home care and expanded dental services for children. Although the federal government had promised to expand its support for these initiatives during the debate on the Medical Care Act, financial constraints made an increase in funding unlikely. Indeed, the Trudeau government also wanted to create a guaranteed annual income and to focus more attention on emerging environmental issues such as air and water pollution, and needed to find the funds to pay for these activities. Not surprisingly, then, Prime Minister Trudeau remarked to Quebec’s Finance Minister, “Mr. Dozois, you will never have another Medicare, I promise you that,” at the federal–provincial first ministers’ meeting in February 1969.